Page 25 - NYSAGD GP Fall 2018

The dentist should begin by collecting pa- Dentists and dietitians have a great oppor- 2011Volume 111, Issue 1, Pages 156–166.e27.
tient and family medical history, identifying tunity to partner together to reduce the soci- DOI: https://doi.org/10.1016/j.jada.2010.10.053.
oral manifestations that may identify poor etal cost of poorly controlled DM. Dentists 13. Moller G, Anderson HK, Snorgaard O. A
diabetic control or elude to first time diag- can help identify patients with prediabetes Systematic Review and Meta-analysis of Nu-
nosis. If available, the dentist should test for and uncontrolled DM, and properly refer to trition Therapy Compared with Dietary Advice
DM diagnosis/control in the dental office. specialists like endocrinologists, RD/RDN, in Patients with Type 2 Diabetes. Am J Clin
A referral to an endocrinologist should be and CDEs to prevent diabetic complications Nutr. 2017 Dec;106(6):1394-1400. doi: 10.3945/
made if a first time diagnosis is suspected. and to provide optimal patient care. ajcn.116.
If a person has diabetes which appears un- 14. Wylie-Rosett J, Delahanty LM. The Diabetes
controlled, he/she should be referred to a References: Prevention Program Research Group. An Inte-
Registered Dietitian who is also a Certified 1. Rowley W, Bezold C, Arikan Y, Byrne E, Kro- gral Role of the Dietitian: Implications of the
Diabetes Educator. If an individual has peri- he S. Diabetes 2030: Insights from Yesterday, Diabetes Prevention Program. J Am Diet Assoc.
odontal disease, it should be treated as well. Today and Future Trends. Popul Health Manag. 2002 Aug; 102(8): 1065–1068.
The American Dietetic Association recom- 2017 Feb 1; 20(1): 6–12.Published online 2017
mends patients with DM to be followed by a Feb 1. doi: 10.1089/pop.2015.0181. Disclaimer: She has no financial disclosures to
Registered Dietitian Nutritionist (RD/RDN) 2. Centers for Disease Control and Prevention. report.
who is also a Certified Diabetes Educator National Diabetes Statistics Report, 2017. Atlan-
(CDE) for proper guidance on diet to con- ta, GA: Centers for Disease Control and Preven- Michelle Routhenstein,
trol blood sugar levels. The RD/RDN/CDE tion, U.S. Dept of Health and Human Services; MS, RD, CDE, CDN, is
should collaborate with the endocrinologist 2017. the owner and president of
and address medication compliance, blood 3. Fowler M. Microvascular and Macrovascular Entirely Nourished LLC.
sugar monitoring, emotional components, Complications of Diabetes. American. Clinical Di- She is a Registered Dieti-
exercise, and sleep regimens with the pa- abetes 2008 Apr; 26(2): 77-82.doi: 10.2337/dia- tian Nutritionist, Certified
tient. The goal of the RD/CDE is to nor- clin.26.2.77. Diabetes Educator, and is
malize and optimize blood sugar, lipid and 4. American Diabetes Association. Diagnosis Certified in Weight Management. She
blood pressure levels while helping the pa- and Classification of Diabetes Mellitus. Dia- graduated with a M.S. in Clinical Nutri-
tient adapt lifelong lifestyle behaviors to re- betes Care. 2010 Jan; 33(Suppl 1): S62–S69. tion from NYU and completed her dietet-
duce diabetic complications. This will help doi: 10.2337/dc10-S062. ic residency at NYU. She has over ten
with controlling and preventing periodontal 5. Al-Maskari A, Al-Maskari M, Al-Sudairy S. years of experience counseling private
disease and infection rate, along with the Oral Manifestations and Complications of Dia- patients on chronic disease prevention
other aforementioned complications. Each betes Mellitus. Sultan Qaboos Univ Med J. 2011 and management. She recently contrib-
individual’s specific lifestyle needs should May; 11(2): 179–186. uted, alongside a team of doctors and
be discussed to provide personalized guid- 6. Daniel R, Gokulaathan S, Shanmugasund- scientists, to developing a risk assess-
ance; this includes personal/cultural pref- aram N, Lakshmigandhan M, Kavin T. Dia- ment to identify individuals who are at
erences, job/home environment, support betes and Periodontal Disease. J Pharm Bio- high risk for chronic disease based on
system, and willingness to change. The RD/ allied Sci. 2012 Aug; 4(Suppl 2): S280–S282. modifiable lifestyle medicine factors.
CDE should maintain the pleasure of eating doi: 10.4103/0975-7406.100251. Michelle is passionate about translating
by only limiting food choices when indicat- 7. Lalla E, Kunzel B, Cheng B, Lamster I.B. nutrition sciences into an easy to under-
ed by scientific evidence. 12 Identification of Unrecognized Diabetes and stand language with long-term imple-
Pre-diabetes in the Dental Setting. Journal of mentable goals.
Research has shown that lifestyle modifi- Dental Research. 2011 July; 90 (7): 855-860.
cation achieved a greater reduction in the doi: 10.1177/0022034511407069.
risk of DM than reliance on medication. 8. Leite R, Marlow N, Fernandes J. Oral
Specifically, a systemic review and me- Health and Type 2 Diabetes. Am J Med Sci.
ta-analysis of type 2 DM nutrition therapy 2013 April ; 345(4): 271–273. doi:10.1097/
from an RD compared with dietary advice MAJ.0b013e31828bdedf.
from other healthcare professionals, showed 9. Chavez EM, Borrell LN, Taylor GW, Ship JA.
a significant reduction in HgA1c, BMI, A longitudinal analysis of salivary flow in control
weight and LDL cholesterol. Specifically, subjects and older adults with type 2 diabetes.
five randomized controlled trials compris- Oral surgery, oral medicine, oral pathology, oral
ing 912 participants in total showed in the radiology, and endodontics. 2001; 91(2):166–73.
first year of intervention (at 6 or 12 months), 10. Gandara B, Morton T. Non-Periodontal Oral
nutrition therapy compared with dietary ad- Manifestations of Diabetes: A Framework for
vice was followed by a 0.45% (95% CI: Medical Care Providers. Diabetes Spectrum 2011
0.36%, 0.53%) lower mean difference in Nov; 24(4): 199-205.doi: 10.2337/diaspect.24.4.199.
HbA1c, a 0.55 (95% CI: 0.02, 1.1) lower 11. Wysocki GP, Daley TD. Benign Migratory
BMI, a 2.1-kg (95% CI: 1.2-, 2.9-kg) lower Glossitis in Patients with Juvenile Diabetes. Oral
weight, and a 0.17-mmol/L (95% CI: 0.11-, Surg Oral Med Oral Pathol. 1987 Jan;63(1):68-
0.23-mmol/L) lower LDL cholesterol. Di- 70.
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etitians played a key role in the overwhelm- 12. Boucher J, Evert A, Daly A, Kulkarni K,
ingly positive Diabetes Prevention Program Rizzotto, J, Burton K, Bradshaw B. American
finding that lifestyle intervention is more Dietetic Association Revised Standards of Prac-
effective than medication in the prevention tice and Standards of Professional Performance
of type 2 diabetes. for Registered Dietitians (Generalist, Special-
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ty, and Advanced) in Diabetes Care. Journal of
Academy of Nutrition and Dietetics. January
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